5 Gonorrhea Symptoms Any Sexually Active Woman Should Know

As far as sexually transmitted infections (STIs) go, gonorrhea can be especially sneaky—most women with gonorrhea don’t show any signs of the infection at all, according to the Centers for Disease Control and Prevention (CDC).

And if they do have symptoms of gonorrhea? They’re often so mild and broad (a little bit of itching, some here-and-there spotting) that they’re easily written off as something less serious, like a yeast infection or UTI.

Gonorrhea is incredibly common, though. Roughly 820,000 infections pop up every year, and more than half of them affect people ages 15 to 24. While incidences of gonorrhea did hit an all-time low back in 2009, the number of reported cases have increased by nearly 50 percent as of 2016, according to the CDC.

What’s more, the STI has become an “urgent public health threat” because it has developed antibiotic resistance to nearly all of the medication used for its treatment in the past. That means antibiotics that used to do the trick simply can’t kill the same bacteria now. In fact, there is only one class of antibiotics (known as cephalosporins) left as a recommended treatment.

Problem is, when left untreated, gonorrhea can lead to pelvic inflammatory disease—a condition where bacteria travels up from the cervix and urethra to the uterus and fallopian tubes—which can cause a severe infection and ultimately lead to infertility, says Huma Farid, MD, an ob-gyn at Beth Israel Deaconess Medical Center in Boston.

So what can you do to protect yourself? Other than preventing the STI in the first place through safe sex practices (always use a condom, people!), there are subtle signs of gonorrhea to keep your eyes peeled for so you can seek treatment ASAP. If you notice any of the following red flags, don’t hesitate to make an appointment with your ob-gyn.

Unusual vaginal discharge

Women who have symptoms with gonorrhea first tend to complain of a thick, yellow vaginal discharge, says Dr. Farid. When gonorrhea infects the cervix, it causes an inflammatory response that produces the substance, she explains. It’s often accompanied with an itchy feeling, too.

Just note if your vagina is itchy but smells more fishy, that could be a sign of bacterial vaginosis. When in doubt, call your doc to figure out what the issue is.

Putting in a tampon or having sex hurts

Painful sex? Struggling to put a tampon? That could be a sign that your cervix, where the infection can occur, is inflamed, says Dr. Farid. If you have gonorrhea, an ob-gyn’s physical exam with their fingers might hurt, too, she says. “Normally, touching the cervix will not be painful, but in a woman with gonorrhea, this would be very painful,” she says.

It burns when you pee

An infection from gonorrhea can also occur in the urethra, the duct that carries urine from the bladder. If you’re infected there, you might notice symptoms when you pee, such as pain, burning, or feeling like you have to go but not being able to (all things you also might notice if you have a urinary tract infection), says Dr. Farid.

Bleeding in between periods

When the cervix becomes inflamed, it bleeds easily, explains Farid. That’s why some women with gonorrhea notice spotting or bleeding in between periods. However, if it’s the only symptom you notice, there are a slew of other things can cause irregular periods—like uterine fibroids, PCOS, or even just stress. Your best bet is to talk to your doc about it to get an accurate diagnosis.

Uncomfortable bowel movements

Yep, gonorrhea can be transmitted through anal sex, meaning unpleasant symptoms can show up in your anus. This includes discharge, itching, soreness, bleeding, and painful bowel movements, according to the CDC.

How to treat gonorrhea

To test for gonorrhea, your doctor will usually take a swab from your vagina or do a urine test. It usually takes about 48 hours to get results.

Then, gonorrhea is usually treated with either a shot of an antibiotic called ceftriaxone and an oral antibiotic, Azithromycin (name brand: Zithromax, or Z-Pak for short), Dr. Farid says. It’s important to take all of the medication to ensure the infection is completely cured. Because certain strains of gonorrhea are becoming more resistant to antibiotics, you should check in with your doc if your symptoms continue to persist following treatment, the CDC says.

As a general rule of them, you shouldn’t have sex for a week after all of your meds have been taken to minimize the risk of spreading gonorrhea to your partner. He or she should also get tested to make sure you haven’t already passed it on.

Even after it clears up, practice safe sex (always use a condom!) and be vigilant about testing. The CDC recommends that women younger than 25 (or older women who have new or sexual multiple partners) get tested for gonorrhea every year.

Cassie ShortsleeveFreelance WriterCassie Shortsleeve is a skilled freelance writer and editor with almost a decade of experience reporting on all things health, fitness, and travel.

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